TOO MUCH MILK

You might be thinking, what is a ‘Milk Baby’? Basically, it’s a term referring to babies and toddlers who suffer from iron deficiency anemia (IDA) as a result of excessive milk consumption. 

WHAT IS EXCESSIVE MILK INTAKE?

A baby or toddler that consumes more than 2-3 cups (16-24oz) of milk daily can be considered excessive.  Generally, it's when they are consuming litres of milk every day (yes, it happens) and thus they can head down a very quick path to IDA.

IDA?  SO WHAT?

Iron deficiency is the most common nutrient deficiency in children.  The typical cause of iron deficiency in younger children (0-24 months) is the excessive intake of cow’s milk or milk substitutes.  When iron in the body is low, there can be a number of harmful effects. It is a serious problem.  A child's brain and body NEED iron. Due to the high demand of a child’s body for iron (necessary for growth and development) and the possibility for long-term impacts of iron deficiency (poor growth, decreased intelligence and IQ) an iron-deficient child must be treated quickly and appropriately.

SIGNS & SYMPTOMS OF IDA

• fatigue

• pale skin & dark circles under the eyes

• pale lips & tongue

• weakness

• poor appetite & possible poor weight gain

• headache or dizziness

• irritability

• PICA - unusual food cravings (paint, dirt, paper)

• impaired growth and development

• in infants and preschoolers, IDA can result in developmental delays and behavioural problems

WHY DOES EXCESSIVE MILK INTAKE CAUSE IDA?

You might be asking “I thought milk was good for babies”.  Milk has some good qualities (protein, calcium, vitamin D, etc.) and children can grow well because of these nutrients. However, cows milk and milk substitutes (like soy, almond, coconut mylks) when introduced too early or when they are a sole source of nutrition, can lead to IDA for a number of reasons.

• Milk and milk substitutes are very poor sources of iron.

• Milk interferes with the body’s ability to absorb iron from food and supplements.

• Cow’s milk can cause intestines to lose small amounts of blood. When blood is lost, iron is lost too.

• Too much milk = lots of liquid = full tummies = less solid foods. Solid foods are where the iron in a child’s diet typically comes from.

• Breastfeeding for extended periods of time, without the addition of iron-rich foods

WHAT CAN BE DONE?

Be ready for a battle.  A child who loves milk, especially in a bottle, will be your toughest competition.  They will cry, scream, throw a tantrum, refuse all food and give you the fight of your life.  You need to persevere because you are fighting for THEIR life.  So, try these approaches:

1. Offer no more than 16-20 ounces of milk per day.

2. Encourage good food sources of iron at each meal.

3. Pair iron-rich foods with Vitamin C sources to increase iron absorption.

4. Try serving 3 meals and 2-3 snacks each day at scheduled times to promote better hunger. Try not to allow grazing in between these times.

5. Offer only a small amount of liquid with meals initially and encourage your child to eat solid foods.

6. If still bottling and over one year of age, wean the child from the bottle as soon as able.

7. If a child has been diagnosed with severe IDA, an iron supplement will be prescribed as food choices will not replenish iron stores alone. Ensure the child takes this supplement as prescribed, make the previous changes and reassess iron status in three months.

If you are concerned your child is iron deficient or has been diagnosed with IDA, please see a paediatrician and/or Registered Dietitian. 

Book an appointment with one of the Nourished Beginnings Dietitians with expertise in treating iron deficiency in children.